AI Article Synopsis
- Most pancreatic tumors, especially those in the head, are typically adenocarcinomas, but some may come from nearby areas like the papilla of Vater or the duodenum, leading to classifications like periampullary neoplasms.
- Surgical intervention, specifically pancreatoduodenectomy, is the primary treatment for these tumors, along with the removal of at least 16 lymph nodes to improve long-term outcomes.
- There is ongoing debate about the best approach to adjuvant chemotherapy after surgery for these tumors, leading to various opinions on how to handle therapeutic management.
Article Abstract
Most tumours in the head of the pancreas are adenocarcinomas of the exocrine pancreas. However, carcinomas located in the head of the pancreas may originate from the papilla of Vater, the distal part of the common bile duct, or the duodenum. Tumours of that region, within 2 cm of the greater duodenal papilla, have been usually described as periampullary neoplasms. Adenocarcinomas separated from the major duodenal papilla and located in the major pancreatic duct, common bile duct, or duodenum are identified as ductal pancreatic carcinomas, distal bile duct cholangiocarcinomas or duodenal carcinomas. Surgical treatment is the only chance for cure. Pancreatoduodenectomy is the procedure of choice. Regional lymphadenectomy and removal of at least 16 lymph nodes are necessary for optimal long-term outcomes. Indications for adjuvant chemotherapy remain controversial. This review evaluates the available data on the pathological assessment of periampullary tumours and discusses the controversies of therapeutic management, emphasising adjuvant treatment.
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| http://dx.doi.org/10.1016/j.suronc.2022.101853 | DOI Listing |
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